Hearing Care 101 — The Hearing Aid Fitting
Hearing care is not a grab-n-go solution — better hearing is a process. However, do you REALLY need an entire appointment just to pick up your hearing devices?
The answer to that question is a resounding YES. A lot happens at a fitting appointment to make sure your world comes alive with sound. Hearing aids are transformative devices that significantly improve the quality of life for individuals with hearing loss, and their effectiveness depends on a proper fitting process.
This process involves customization, programming, physical fit, education, and follow-up care. This guide walks through each stage of the hearing aid acquisition and fitting process, ensuring a smooth transition to better hearing.
What Happens at a Hearing Test
A hearing test is a comprehensive and straightforward process designed to evaluate your auditory health. What can you expect from the moment you step into your audiologist’s office? You’ll first check in at the front desk. The staff will likely ask you to fill out a brief medical history form, including details about your hearing concerns, any recent illnesses, medications, and family history of hearing issues.
Next, you’ll meet your audiologist, a specialist trained in diagnosing and treating hearing disorders. They will take time to discuss your medical history, lifestyle, and specific concerns.
Your audiologist will then begin with a physical examination of your ears using an otoscope. This allows them to check for visible issues such as earwax buildup, infections, or abnormalities in the ear canal or eardrum.
Once the physical exam is complete, your audiologist will guide you through a series of hearing tests. Each test is designed to measure different aspects of your hearing:
Types of Hearing Tests and What They Measure
1. Pure-Tone Audiometry
This test evaluates an individual’s ability to hear sounds at different frequencies and volumes.
2. Speech Audiometry
Speech audiometry assesses how well a patient can hear and understand spoken words.
3. Tympanometry
Tympanometry measures the movement of the eardrum in response to changes in air pressure.
4. Otoacoustic Emissions (OAE)
This test evaluates the function of the hair cells in the inner ear by measuring sounds generated in response to auditory stimuli.
5. Auditory Brainstem Response (ABR)
ABR testing measures the brain’s response to sound stimuli, helping to identify hearing loss caused by nerve or brain pathway issues.
How Hearing Experts Interpret Test Results
Hearing test results are typically displayed on an audiogram, a visual chart that shows the patient’s hearing thresholds at different frequencies. Audiologists analyze the data to determine the degree (mild, moderate, severe, or profound) and type (conductive, sensorineural, or mixed) of hearing loss.
For instance:
- Conductive Hearing Loss: Caused by issues in the outer or middle ear, such as blockages or infections
- Sensorineural Hearing Loss: Results from damage to the inner ear or auditory nerve
- Mixed Hearing Loss: A combination of conductive and sensorineural issues
By interpreting these results, audiologists can pinpoint the most effective treatment options and discuss them with the patient.
Hearing Aid Selection
Once you’ve completed your hearing test, your audiologist will guide you through the process of selecting a hearing aid that best suits your level of hearing loss, lifestyle, and personal preferences. There are two main styles to consider: behind-the-ear (BTE) and in-the-ear (ITE) devices.
BTE hearing aids sit behind the ear and are connected to either a pre-made dome or a custom earmold that fits inside the ear canal. ITE hearing aids, on the other hand, fit directly into the ear and are custom molded for a secure fit. These are often recommended for those with mild to moderate hearing loss and are more discreet, though they may have fewer advanced features due to their compact size.
What happens when your hearing aids arrive to your hearing care professional’s office? Your provider will call you and set up an appointment for a hearing aid fitting, where they will customize your new hearing aids to match your specific hearing loss needs.
What can I expect at my hearing aid fitting?
Hearing aids are wonderful, sophisticated devices. But better hearing is a journey, not a transaction. That’s why we bring you into the office and spend some time with you answering questions and demonstrating features. Your initial fitting process typically lasts 45 minutes to two hours, during which the audiologist fine-tunes the hearing aid and conducts verification tests.
You may ask, “What does a typical fitting look like?” Read on for the answer.
Making Sure Your New Hearing Aids Fit
Before anything else can happen, you have to pull your devices out of the box and slide them in your ears to ensure they fit you. If not, your audiologist will have to exchange them for ones that do, which most likely means returning for another fitting appointment.
A well-fitted hearing aid ensures comfort and effective amplification.
A poorly fitting hearing aid can cause discomfort or feedback noise. The audiologist ensures a secure fit, adjusting dome styles or tubing as needed.
After you’ve had a moment to hear with your “new ears,” the fine-tuning can begin.
Programming Your Devices and Verifying They Meet Your Specific Needs
If everything fits, your audiologist will program your hearing aids with fitting software. Again, hearing aids are not one-size-fits-all devices. They are customized and programmed to suit the user’s specific hearing loss, preferences, and lifestyle needs.
Once a patient’s hearing aids arrive at the audiologist’s office, they are connected to specialist software for fine-tuning. The audiologist programs the amplification levels, frequency response, and noise reduction settings based on your audiogram.
Your Audiogram Indicates:
- The sound frequencies that need to be amplified, and by how much
- The sound frequencies that you can hear just fine
- The sound frequencies that can remain loud but might need to be adjusted to minimize your discomfort
Customizable Features in Hearing Aids
- Volume Adjustments: Automatic or manual controls suit different environments.
- Frequency Amplification: Specific frequencies are amplified based on individual hearing loss.
- Noise Reduction: This reduces background noise for clearer speech perception.
- Wireless Accessories: Bluetooth connectivity allows seamless connection to devices.
- Remote Controls: They enable discreet volume and program adjustments.
Specialist Software and Tools
Once programmed and fine-tuned, if your audiologist is using best practices, they’ll follow up with real-ear measurement (REM). Advanced software allows audiologists to analyze hearing aid performance in real time.
REM is conducted using probe microphone measurements to ensure the hearing aid delivers the correct amplification inside the ear canal. It involves inserting a thin tube into the ear canal to measure how sound is amplified. Your audiologist can then confirm whether the volume reaching your eardrum is the correct amount based on your audiogram.
Education and Instruction
Hearing aid developers make sure today’s hearing aids are as user-friendly as possible, but you still need to learn the basics.
By the time you leave your fitting appointment, you should know:
- The features of the charging station, or, how to change and dispose of batteries
- How to change programs and adjust volume
- How to clean and maintain your hearing aids
- How certain features work, such as connecting via telecoil (t-coil) to a looping system or streaming audio from your smartphone directly to your hearing aids
- How to use remote controls and other accessories
You’ll receive instruction guides, cleaning tools, a storage case, and a charging station (or supply of batteries).
Daily Care Routines
- Cleaning: Use a dry cloth or specialized cleaning tools.
- Battery Maintenance: Charge rechargeable batteries nightly; replace disposable batteries when weak.
- Storage: Keep hearing aids dry and store them in a protective case when not in use.
Troubleshooting Common Issues
- Weak or No Sound: Check battery and earwax blockages.
- Feedback Noise: Ensure a snug fit and adjust volume levels.
- Distorted Sound: Clean microphone ports and tubing.
Understanding What’s Ahead: Adaptation and Follow-Up
Today’s hearing aids are easy to use, but your brain can be out of practice. It has to suddenly make sense of sounds it hasn’t heard in a long time, so there is an adjustment period. It can take several weeks to adjust to new hearing aids, requiring periodic fine-tuning sessions.
New users may experience:
- Echoing sounds or their own voice sounding overly loud
- Difficulty distinguishing speech from background noise
- Gradual improvement as the brain adapts
Follow-ups allow audiologists to fine-tune hearing aids and address any concerns. Adjustments may be needed as users become accustomed to amplified sounds.
Patience and persistence are key during this period.
Your audiologist will discuss this in more detail, so you know what to expect and don’t get discouraged. They’ll also give you a wearing schedule for the first few weeks, so you don’t overdo it, easing you into this new world of sound is the best way to ensure success.
Scheduling the First Follow-Up Appointment
As you live your life, you’ll enjoy the benefits of better hearing, but you’ll also notice ways your devices could help more, especially in noisy environments.
That’s why you’ll schedule a follow-up appointment. After a few weeks, a final fitting ensures optimal comfort and performance. Your audiologist expects you to have feedback on how to improve your listening experience. You’ll also no doubt have questions you’ve thought of since the fitting appointment.
The hearing aid fitting process is a detailed and personalized journey that ensures users receive the best possible hearing experience. From customization and programming to ongoing support, each step plays a vital role in optimizing hearing aid performance. By understanding what to expect, patients can confidently embark on their path to better hearing with the guidance of a qualified audiologist.
Learn the Types of Hearing Care Providers
See how audiologists, hearing instrument specialists, and ear doctors differ.